Libman-Sacks endocarditis
| Libman-Sacks endocarditis | |
| ICD-10 | I39, M32.1 |
|---|---|
| ICD-9 | 710.0 |
| DiseasesDB | 29254 |
| eMedicine | med/1295 |
| MeSH | D008180 |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]
Overview
Libman-Sacks endocarditis is a form of nonbacterial endocarditis that is seen in systemic lupus erythematosus. It is the most common cardiac manifestation of lupus. It can be associated with the development of aortic insufficiency. LSE is a sterile and verrucous vegetation around the heart valves. LSE is usually associated with autoimmune diseases especially SLE and APS. LSE mostly affects mitral and aortic heart valves, which may cause thromboembolic cerebrovascular events, valvular regurgitation, and increased risk of infective endocarditis. Although APS and valvular involvements are not rare, and have mostly low clinical significance, they could cause severe complications. Secondary APS compared to primary APS also have higher rate of cardiac involvement, mostly due to the autoimmune causes related to the SLE. Here, we report three cases of LSE in patients with SLE and secondary APS diagnosed after presenting with neurological manifestations.
Pathophysiology
The vegetations are formed from strands of fibrin, neutrophils, lymphocytes, and histiocytes. The mitral valve is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. Libman-Sacks lesions rarely produce significant valve dysfunction and the lesions only rarely embolize.[1][2][3][4][5][6][7]
Pathology
The pathology is the same as nonbacterial thrombotic endocarditis except focal necrosis (hematoxylin bodies) can be found only in Libman-Sacks endocarditis.
Historical Perspective
It was named after American physicians Emanuel Libman and Benjamin Sacks. [8]
References
- ↑ Mohammadi Kebar Y, Avesta L, Habibzadeh A, Hemmati M (2019). "Libman-Sacks endocarditis in patients with systemic lupus erythematosus with secondary antiphospholipid syndrome". Caspian J Intern Med. 10 (3): 339–342. doi:10.22088/cjim.10.3.339. PMC 6729157 Check
|pmc=value (help). PMID 31558998. - ↑ Murtaza G, Iskandar J, Humphrey T, Adhikari S, Kuruvilla A (2017). "Lupus-Negative Libman-Sacks Endocarditis Complicated by Catastrophic Antiphospholipid Syndrome". Cardiol Res. 8 (2): 57–62. doi:10.14740/cr534e. PMC 5421487. PMID 28515823.
- ↑ Bouma W, Klinkenberg TJ, van der Horst IC, Wijdh-den Hamer IJ, Erasmus ME, Bijl M; et al. (2010). "Mitral valve surgery for mitral regurgitation caused by Libman-Sacks endocarditis: a report of four cases and a systematic review of the literature". J Cardiothorac Surg. 5: 13. doi:10.1186/1749-8090-5-13. PMC 2859362. PMID 20331896.
- ↑ Bai Z, Hou J, Ren W, Guo Y (2015). "Diagnosis and surgical treatment for isolated tricuspid Libman-Sacks endocarditis: a rare case report and literatures review". J Cardiothorac Surg. 10: 93. doi:10.1186/s13019-015-0302-1. PMC 4494164. PMID 26152222.
- ↑ "StatPearls". 2019. PMID 30422459.
- ↑ Wang Y, Ma C, Yang J, Liu S, Zhang Y, Zhao L; et al. (2015). "Libman-sacks endocarditis exclusively involving the tricuspid valve in a patient with systemic lupus erythematosus". J Clin Ultrasound. 43 (4): 265–267. doi:10.1002/jcu.22180. PMID 24925796.
- ↑ Perier P, Jeserich M, Vieth M, Pohle K, Hohenberger W, Diegeler A (2011). "Mitral valve reconstruction in a patient with Libman-Sacks endocarditis: a case report". J Heart Valve Dis. 20 (1): 103–6. PMID 21404907.
- ↑ Libman E, Sacks B: A hitherto undescribed form of valvular and mural endocarditis. Arch Intern Med 1924; 33: 701-37.
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